Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Will we be starting from scratch on the space?

Yes

No

Does the space require any type of construction or structural changes?

Yes

No

Have you worked with a designer in the past?

Yes

No

What styles are you drawn to? Please select all that apply.

New Modern/Organic Modern

Mid-Century Modern

Post Modern

Contemporary

Transitional

Traditional

Farmhouse

French Country

Coastal

Parisian/French Provincial

Eclectic

Hollywood Regency

Art Deco

Minimalism

Maximalism

Scandanavian

Bohemian

Rustic

Industrial

Shabby Chic